Prologue and Introduction
Autism spectrum disorder is a complex, multiply expressed disorder of the core of human functioning—social interaction. The diagnostic criteria for autism spectrum disorder (ASD) have undergone significant evolution with a current prevalence rate of appro
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Prologue and Introduction Raymond G. Romanczyk
Autism spectrum disorder is a complex, multiply expressed disorder of the core of human functioning—social interaction. Leo Kanner (Kanner, 1943) first identified the syndrome of autism in the early 1940s, using the term “early infantile autism” to connote his assertion that this was a disorder that was present from birth. Importantly, of the many characteristics Kanner described, the most important was the characterization of aloof, highlighting the core deficit in social interaction. While Kanner’s initial publication described only 11 children, he set the stage for further examination of this, at the time, rare disorder. For decades the prevalence for autism was in the 4.5 per 10,000 range as would be expected for a rare disorder. There were of course some differences in various estimates of prevalence, from a low of 2 per 10,000 to a high of 13.9 per 10,000, but all in this very low prevalence range. Then in the late 1990s, estimates began to rise. The California Department of Developmental Services reported in 1999 a prevalence of 20 per 10,000. Some of the reporting at the time distorted the magnitude of change by reporting the figure as 1 per 500 that had more impact on perception of increase than the standard per 10,000 method. This could be viewed as the start of the autism “epidemic.” In rapid succession, reported prevalence began a steady climb. This pattern is in parallel to standards for diagnosis and follows a clear pattern (Romanczyk, Turner, Sevlever, & Gillis, 2014). Autism was first introduced into formal psychiatric diagnosis in the Diagnostic and Statistical Manual (DSM),
R.G. Romanczyk (*) Institute for Child Development, Binghamton University, Vestal Parkway East, Binghamton, NY 13902, USA e-mail: [email protected] © Springer International Publishing Switzerland 2016 R.G. Romanczyk, J. McEachin (eds.), Comprehensive Models of Autism Spectrum Disorder Treatment, DOI 10.1007/978-3-319-40904-7_1
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version III, of the American Psychiatric Association in 1980 under Kanner’s term “infantile autism.” Six characteristics were required: 1. 2. 3. 4.
Onset before 30 months of age A pervasive lack of responsiveness to other people Gross deficits in language development When speech is present, peculiar speech patterns such as immediate and delayed echolalia, metaphorical language, and pronoun reversal 5. Bizarre responses to various aspects of the environment (e.g., resistance to change, peculiar interest in or attachments to objects) 6. The absence of delusions, hallucinations, loosening of associations, and incoherence as observed in individuals diagnosed with schizophrenia Relatively quickly, in 1987, DSM-III was revised, DSM-III-R, with significant changes. The characteristics required were reduced to three: 1. Impairment in reciprocal social interaction 2. Impairment in verbal and nonverbal communication 3. Restrictive repertoire of activities and interests Within these three categories were numerous specific examples of symptoms, wi
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